Physicians’ loyalty to branded medicines in low-middle-income countries: A structural equation modeling

Mehralian, Gholamhossein; Sharif, Zahra; Yousefi, Nazila; Akhgari, Mahdi

doi:10.1177/1741134316673227

Cited by 5 publications

(24 citation statements)

References 35 publications

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“…Another study in Saudi Arabia concluded that there is no rational in prescribing of drugs to the insured and uninsured patients in terms of company and variety of drugs [48]. There is a practice of prescribing medicine from a particular company based on the individual benefit of the physician [49,50] and participants of this study also reported such behaviors contributing to high drop out.…”

Section: Discussionmentioning

confidence: 81%

Status and determinants of enrollment and dropout of health insurance in Nepal: an explorative study

Ranabhat

Subedi²,

Karn³

2020

Cost Eff Resour Alloc

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Background Compared to other countries in the South Asia Nepal has seen a slow progress in the coverage of health insurance. Despite of a long history of the introduction of health insurance (HI) and a high priority of the government of Nepal it has not been able to push rapidly its social health insurance to its majority of the population. There are many challenges while to achieve universal health insurance in Nepal ranging from existing policy paralysis to program operation. This study aims to identify the enrollment and dropout rates of health insurance and its determinants in selected districts of Nepal. Methods The study was conducted while using a mixed method including both quantitative and qualitative approaches. Numerical data related to enrollment and dropout rates were taken from Health Insurance Board (HIB) of Nepal. For the qualitative data, three districts, Bardiya, Chitwan, and Gorkha of Nepal were selected purposively. Enrollment assistants (EA) of social health insurance program were taken as the participants of study. Focus group discussions (FGD) were arranged with the selected EAs using specific guidelines along with unstructured questions. The results from numerical data and focus group discussions are synthesized and presented accordingly. Results The findings of the study suggested variation in enrollment and dropout of health insurance in the districts. Enrollment coverage was 13,545 (1%), 249,104 (5%), 1,159,477 (9%) and 1,676,505 (11%) from 2016 to 2019 among total population and dropout rates were 9121(67%), 110,885 (44%) and 444,967 (38%) among total enrollment from 2016 to 2018 respectively. Of total coverage, more than one-third proportion was subsidy enrollment—free enrollment for vulnerable groups. The population characteristics of unwilling and dropout in social health insurance came from relatively well-off families, government employees, businessman, migrants’ people, some local political leaders as well as the poor class families. The major determinants of poor enrollment and dropout were mainly due to unavailability of enough drugs, unfriendly behavior of health workers, and indifferent behavior of the care personnel to the insured patients in health care facilities and prefer to take health service in private clinic for their own benefits. The long maturation time to activate health service, limited health package and lack of copayment in different types of health care were the factors related to inefficient program and policy implementation. Conclusion There is a high proportion of dropout and subsidy enrollment, the key challenge for sustainability of health insurance program in Nepal. Revisiting of existing HI policy on health care packages, more choices on copayment, capacity building of enrollment assistants and better coordination between health insurance board and health care facilities can increase the enrollment and minimize the dropout.

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Section: Discussionmentioning

confidence: 81%

Status and determinants of enrollment and dropout of health insurance in Nepal: an explorative study

Ranabhat

Subedi²,

Karn³

2020

Cost Eff Resour Alloc

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“…with context-specific modifications 17. Three items used to measure the construct of habit persistence in the current study (Online appendix 1) 19,26. This study employed a five-point rating scale (‘strongly disagree’ to ‘strongly agree’).…”

Section: Methodsmentioning

confidence: 99%

“…Research to date has tended to focus on measuring a proxy for physicians’ decision making such as prescribing quality, prescription loyalty, the improving prescribing, and how prescriptions are made in general 12,19,23,26-29. They used the number of prescriptions or patients who received it, panel data, clinical measures, and physician reports to measure prescribing decision 12,27,30,31.…”

Section: Introductionmentioning

confidence: 99%

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Development and validation of an instrument designed to measure factors influencing physician prescribing decisions

Murshid¹,

Mohaidin²,

Zayed³

2019

Pharm Pract (Granada)

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Background:Previous attempts to develop an instrument to measure factors that influence prescribing decisions among physicians were relatively insufficient and lacked validation scale.Objective:We present a new tool that attempts to address this shortcoming. Hence, this study aims to develop and validate a self-administrated instrument to explain factors that influence the prescribing decisions of physicians.Methods:The questionnaire was developed based on literature and then subjected to an exhaustive assessment by a board of professionals and a pilot examination before being administered to 705 physicians. Three pre-tests were carried out to evaluate the quality of the survey items. In pre-test 1, after items are generated and the validity of their content is assessed by academics and physicians. In pre-test 2, the scale is carried out with a small sample of 20 respondents of physicians. In pre-test 3, fifty drop-off questionnaires were piloted amongst physicians to test the reliability.Results:On the basis of partial least squares structural equation modelling (PLS-SEM) analyses using SmartPLS 3, the content and convergent validity of the instrument were confirmed with 44 items grouped into four categories, namely, marketing efforts, patient characteristics, pharmacist variables, and contextual factors with 13 reflective constructs.Conclusions:The study outcomes prove that the scale is more valid and reliable for measuring factors that influence the decision of the physician to prescribe the drug. The development and presentation of a scale of thirteen factors related to physicians prescribing decisions help to ensure valid findings and facilitates comparisons of studies and research settings.

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“…Fischer et al (2010) reported that the quality and entry order of pharmaceutical products can affect the maximum sales and the time to reach the maximum in PLC curves [27]. Some studies have shown the positive effect of advertisements to physicians, pharmacists, and the patients on the sales of prescription and non-prescription drugs [28][29][30], and discussed that R and D and quality could affect sales in the pharmaceutical industry [31]. PLC studies in other products have highlighted the importance of price and competition on the PLC curves.…”

Section: Introductionmentioning

confidence: 99%

Developing a System Dynamic Model for Product Life Cycle Management of Generic Pharmaceutical Products: Its Relation with Open Innovation

Mousavi

Mohammadzadeh

Zare

2022

Journal of Open Innovation: Technology, Market, and Complexity

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The purpose of this study is to identify elements that influence the sale of generic pharmaceutical products during their life cycle in order to achieve more comprehensive planning and to prevent a decline stage of the product life cycle (PLC). We used a system dynamic model to identify the behaviors of demand, supply, and competition as three major subsystems of PLC in generic pharmaceutical products. We first investigated the PLC patterns of 527 medicines to identify their “reference mode”, determined the causal loop of the pharmaceuticals phase of PLC based on both an in-depth literature review and experts’ opinions, and finally simulated a quantitative dynamic model based on real-world data between 2012 and 2019 from Iran. Based on the results, “total demand and accurate forecasting”, “marketing efforts”, and “R and D activities of a firm” are the most critical factors involved in the formation of a generic drug PLC. An increase of 20–50% of manufacturers’ marketing and R and D activities can raise sales by more than 50% in the decline stage of the PLC. The product life cycle can give generic manufacturers more insights into the processes leading to declining sales of their products. PLC may help to prevent a product from entering the decline stage even if the total demand for a generic drug is dropping in the market.

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Physicians’ loyalty to branded medicines in low-middle-income countries: A structural equation modeling

Cited by 5 publications

References 35 publications

Status and determinants of enrollment and dropout of health insurance in Nepal: an explorative study

Status and determinants of enrollment and dropout of health insurance in Nepal: an explorative study

Development and validation of an instrument designed to measure factors influencing physician prescribing decisions

Developing a System Dynamic Model for Product Life Cycle Management of Generic Pharmaceutical Products: Its Relation with Open Innovation

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